Provider Demographics
NPI:1356072615
Name:JONES, TERELL LAMAR (MSW)
Entity Type:Individual
Prefix:MR
First Name:TERELL
Middle Name:LAMAR
Last Name:JONES
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6271 SAINT AUGUSTINE RD STE 24-1011
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-2523
Mailing Address - Country:US
Mailing Address - Phone:904-608-4338
Mailing Address - Fax:
Practice Address - Street 1:7855 ARGYLE FOREST BLVD STE 703
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-7705
Practice Address - Country:US
Practice Address - Phone:904-370-3832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-18
Last Update Date:2022-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW16917104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker